44D2107298 CLIA NUMBER - HUMBOLDT FAMILY WALK-IN CLINIC

Laboratory Demographics

CLIA Number: 44D2107298

Facility Name: HUMBOLDT FAMILY WALK-IN CLINIC

Facility Address:
1600 COLEMAN DRIVE
HUMBOLDT, TN
ZIP 38343
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Facility Phone Number: 731 470-4020

Facility Type: Physician Office

Certificate Type: Certificate of Compliance

NPI Number: 1841404035

Taxonomy: 363LF0000X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	44D2107298
LAB Type	Physician Office
Facility Name	HUMBOLDT FAMILY WALK-IN CLINIC
Street	1600 COLEMAN DRIVE
City	HUMBOLDT
State	TN
ZIP	38343
Phone	731 470-4020
CertificateType	2
CertificateEffectiveDate	4/4/2023
CertificateExpirationDate	4/3/2025
FacilityType	Compliance

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This page was last updated on: 4/23/2024